Rhythmic auditory cueing to improve walking in patients with neurological conditions other than Parkinson's disease - what is the evidence?

Purpose: To investigate whether synchronising over-ground walking to rhythmic auditory cues improves temporal and spatial gait measures in adults with neurological clinical conditions other than Parkinson's disease. Method: A search was performed in June 2011 using the computerised databases AGELINE, AMED, AMI, CINAHL, Current Contents, EMBASE, MEDLINE, PsycINFO and PUBMED, and extended using hand-searching of relevant journals and article reference lists. Methodological quality was independently assessed by two reviewers. A best evidence synthesis was applied to rate levels of evidence. Results: Fourteen studies, four of which were randomized controlled trials (RCTs), met the inclusion criteria. Patient groups included those with stroke (six studies); Huntington's disease and spinal cord injury (two studies each); traumatic brain injury, dementia, multiple sclerosis and normal pressure hydrocephalus (one study each). The best evidence synthesis found moderate evidence of improved velocity and stride length of people with stroke following gait training with rhythmic music. Insufficient evidence was found for other included neurological disorders due to low study numbers and poor methodological quality of some studies. Conclusion: Synchronising walking to rhythmic auditory cues can result in short-term improvement in gait measures of people with stroke. Further high quality studies are needed before recommendations for clinical practice can be made.